Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00284 | Date 22/10/2019 |
| Token No | SM/19-20/992 06/12/2019 | Serial | 013 |
| Patient Name | Mrs. RINA CHATTERJEE | Contact No | 8697613628 |
| Address | 24A/2 CHAKLAPARA PRABASHNAGAR | Age | 70 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||